tbuckley/cabot-search huggingface dataset:
Empagliflozin Normalizes Fasting Hyperglycemia and Improves Postprandial Glucose Tolerance in Totally Pancreatectomized Patients: A Randomized, Double-Blind, Placebo-Controlled Crossover Study
Authors: Mille Baekdal, Sophie W. Nielsen, Carsten P. Hansen, Jan H. Storkholm, Gerrit van Hall, Bolette Hartmann, Jens J. Holst, Tina Vilsbøll, Asger Lund, Filip K. Knop
Journal: Diabetes Care (2023)

Insulin remains the only glucose-lowering treatment modality recommended for totally pancreatectomized patients. We investigated the effects of the sodium-glucose cotransporter 2 inhibitor empagliflozin on fasting and postprandial glucose concentrations in pancreatectomized patients and matched healthy control participants.In a randomized, double-blind, placebo-controlled crossover study, 10 pancreatectomized patients and 10 matched control participants underwent two 3-h liquid mixed meal tests preceded by two doses of 25 mg empagliflozin (administered the night before and in the morning of the meal test) or placebo, respectively. Basal insulin was administered as usual, but bolus insulin was omitted before the meal test during experimental days.Compared with placebo, empagliflozin lowered fasting plasma glucose (5.0 ± 0.4 vs. 7.9 ± 0.9 mmol/L [mean ± SEM], P = 0.007) and postprandial plasma glucose excursions as assessed by baseline-subtracted area under the curve (1,080 [733; 1,231] vs. 1,169 [1,036; 1,417] pmol/L × min [median (25th and 75th percentiles)], P = 0.014) in the pancreatectomized patients. In the control participants, empagliflozin lowered fasting plasma glucose compared with placebo (5.1 ± 0.1 vs. 5.5 ± 0.1 mmol/L, P = 0.008) without affecting postprandial glucose excursions significantly. The pancreatomy group exhibited greater postprandial glucagon excursions compared with the control group on both experimental days (P ≤ 0.015); no within-group differences between days were observed.Empagliflozin administered the day before and immediately before a standardized liquid mixed meal test normalized fasting hyperglycemia and improved postprandial glucose tolerance in pancreatectomized patients.
Incidental Uptake in a Subacute Stroke on 18F-Piflufolastat PSMA PET/CT
Authors: Miles C. Lewis, Daniel J. Wale, Eric Liao, Benjamin L. Viglianti
Journal: Clinical Nuclear Medicine (2023)

Prostate-specific membrane antigen (PSMA) PET/CT has proven to be effective in the evaluation of prostate cancer and has become increasingly used clinically as multiple radiopharmaceuticals have become commercially available. With increasing use, incidental uptake from a variety of nononcologic processes will be encountered and considered interpretive pitfalls. We outline a case of a 71-year-old man who underwent imaging with PSMA PET/CT, which demonstrated uptake in the left parietal-temporal junction that was shown to be a subacute stroke. This case demonstrates a reported cause of uptake on PSMA PET for which the underlying mechanism is not yet well understood.
Mesenteric Castleman Disease Misdiagnosed as Lymph Node Metastasis of Rectal Cancer on 18F-FDG PET/CT
Authors: Meixi Liu, Jiaolin Zhou, Wenjia Zhu, Li Huo, Wuying Cheng
Journal: Clinical Nuclear Medicine (2023)

Two years ago, a 64-year-old man underwent an 18 F-FDG PET/CT for staging rectal cancer. Besides the hypermetabolic rectal lesion, the image revealed a mesenteric lymph node with intense activity and multiple lung nodules with slight FDG uptake, which were highly suspected of metastases. After surgery and multiple cycles of chemotherapy, the follow-up 18 F-FDG PET/CT showed remission of all lesions except for the enlarged mesenteric lymph node with higher metabolic activity. Serum CEA remained normal during the follow-up. Postoperative pathology of the mesenteric lymph node confirmed Castleman disease.
Superior Identification of Metastatic Lesions by 68Ga-FAPI-46 to 18F-FDG PET/CT in a Case of SMARCA4-Deficient Undifferentiated Carcinoma of Stomach
Authors: Yizhen Pang, Jiayu Cai, Liang Zhao, Weizhi Xu, Haojun Chen
Journal: Clinical Nuclear Medicine (2023)

SMARCA4-deficient undifferentiated carcinoma is a new clinical entity characterized by SMARCA4 inactivation and has a dismal prognosis because of rapid growth. In this case, we reported 18 F-FDG and 68 Ga-FAPI-46 PET/CT imaging findings in a patient with SMARCA4-deficient undifferentiated carcinoma of stomach. 68 Ga-FAPI-46 PET/CT showed much higher tumor-to-background contrast of primary tumor and revealed more metastatic lesions than 18 F-FDG PET/CT. This case demonstrated the superiority of 68 Ga-FAPI PET/CT over 18 F-FDG for identifying both primary and metastatic lesions in SMARCA4-deficient undifferentiated carcinoma. This observation may add the information on the benefit of FAPI PET in oncology imaging.
177Lu-FAP-2286 Therapy in a Case of Recurrent Bladder Cancer With Multiple Metastatic Lesions
Authors: Linwei Li, Jian Yang, Dengsai Peng, Yu Zhang, Yue Chen
Journal: Clinical Nuclear Medicine (2023)

We reported a 73-year-old man who was diagnosed with the recurrence of bladder tumor received 177 Lu-FAP-2286 treatment. Encouragingly, radiological remission and alleviation of his symptom were noted. In addition, the patient did not have any adverse effects.
68Ga-DOTATATE PET/CT in the Initial Diagnosis of Patients With Clinical, Imaging, and/or Biochemical Suspicion of a Neuroendocrine Tumor
Authors: Ur Metser, Shereen Ezzat, Simron Singh, Sten Myrehaug, Shiva Rahimi, Daryl Gray, Amit Singnurkar
Journal: Clinical Nuclear Medicine (2023)

Purpose The aim of this study was to assess the yield of somatostatin receptor PET in patients with clinical, imaging, and/or biochemical suspicion of a neuroendocrine tumor (NET). Patients and Methods This analysis includes patients referred for the initial diagnosis of an unconfirmed NET, as part of a prospective, single-arm registry study (NCT03873870) assessing the utility of 68 Ga-DOTATATE PET/CT in the management of NETs. Inclusion criteria to this cohort consisted of elevated biomarkers and/or clinical presentation suspicious for a NET, with negative conventional cross-sectional imaging, or presence of a lesion suspicious for a NET on conventional imaging, not amenable for biopsy. Patients with histological confirmation of a NET were excluded. Results There were 220 patients included between April 2019 and March 2022 with a mean age ± SD of 59.5 ± 16.1 years with biochemical, morphological, and/or clinical suspicion of a NET. Overall, 132/220 patients (60%) had a positive 68 Ga-DOTATATE PET/CT. 68 Ga-DOTATATE PET/CT confirmed a type 2 somatostatin receptor overexpressing tumor in 123/171 (71.9%) of patients with a radiographically suspicious abnormality. The positivity rate for pancreatic, small bowel/mesenteric, adrenal, and other sites was 78/96 (81.2%), 38/57 (66.7%), 7/7 (100%), and 1/11 (9.1%), respectively. 68 Ga-DOTATATE PET/CT was positive in 9/49 (18.4%) of those with a biochemical and/or clinical suspicion of a NET. Conclusions 68 Ga-DOTATATE PET/CT is positive in nearly 3 of 4 patients with morphological suspicion of a NET, with the highest yield in those with pancreatic and small bowel or mesenteric masses, and in approximately 1 of 6 patients with biochemical and/or clinical suspicion of a NET.
Anti-LGI1 Autoimmune Epilepsy
Authors: Brian J. Burkett, Derek R. Johnson, Christopher H. Hunt, Steven A. Messina, Stephen M. Broski
Journal: Clinical Nuclear Medicine (2023)

Abstract Leucine-rich glioma inactivated 1 autoimmune encephalitis is a treatable cause of autoimmune epilepsy associated with faciobrachial dystonic seizures—a rare form of epilepsy with frequent brief seizures primarily affecting the arm and face. We report a case with characteristic imaging findings. 18 F-FDG PET/CT demonstrated severe hypometabolism in the left basal ganglia, a regional abnormality associated with leucine-rich glioma inactivated 1 encephalitis.
Tolerability and Efficacy of the Anticluster of Differentiation 47 Antibody Magrolimab Combined With Azacitidine in Patients With Previously Untreated AML: Phase Ib Results
Authors: Naval G. Daver, Paresh Vyas, Suman Kambhampati, Monzr M. Al Malki, Richard A. Larson, Adam S. Asch, Gabriel Mannis, Wanxing Chai-Ho, Tiffany N. Tanaka, Terrence J. Bradley, Deepa Jeyakumar, Eunice S. Wang, Kendra Sweet, Hagop M. Kantarjian, Guillermo Garcia-Manero, Rami Komrokji, Guan Xing, Giridharan Ramsingh, Camille Renard, Joshua F. Zeidner, David A. Sallman
Journal: Journal of Clinical Oncology (2023)

Magrolimab is a first-in-class humanized monoclonal antibody against cluster of differentiation 47, an antiphagocytic signal used by cancer cells to evade phagocytosis. Azacitidine upregulates prophagocytic signals on AML cells, further increasing phagocytosis when combined with magrolimab. We report final phase Ib data for magrolimab with azacitidine in patients with untreated AML ineligible for intensive chemotherapy (ClinicalTrials.gov identifier: NCT03248479).
Pulmonary Cryptococcosis
Authors: Mengna Liu, Huipan Liu, Xi Chen, Song Zhang, Liang Cai
Journal: Clinical Nuclear Medicine (2023)

Abstract A 57-year-old woman without hepatitis B or immunodeficiency presented with right upper abdominal pain and cough for 3 months. CT revealed one nodule in the lung and another in the liver. Both 18 F-FDG and 68 Ga-FAPI PET/CT showed increased tracer uptake in these 2 nodules, suggesting pulmonary carcinoma with hepatic metastasis. Finally, biopsies of these 2 nodules demonstrated the diagnoses of hepatic adenocarcinoma and pulmonary cryptococcosis. This case highlights that cryptococcosis can be FAPI-avid.
Thyroid Accumulation of 99mTc-DTPA in Graves Disease
Authors: Peng Zhong, Jiahuan Yang, Yimiao Wang, Li Wei, Libo Chen
Journal: Clinical Nuclear Medicine (2023)

Abstract 99m Tc-DTPA dynamic renal scintigraphy for evaluating glomerular filtration rate was performed in a 29-year-old woman with hyperuricemia and Graves disease. Subsequently, 99m Tc-DTPA orbital scintigraphy was conducted to determine the activity of Graves ophthalmopathy. Thyroid accumulation of 99m Tc-DTPA was incidentally identified. This should be cautiously distinguished from 99m Tc-pertechnetate uptake, considering that the salivary glands, oral cavity, and stomach were not visualized. Our case demonstrates that augmentation of blood supply, enhancement of capillary permeability, and accumulation of inflammatory exudate may be involved in the pathological process of Graves disease.
Increased Uptake of Brown Tumor in 99mTc-HYNIC-TOC Scintigraphy Mimicking Postoperative Recurrence of Tumor-Induced Osteomalacia
Authors: Yuwei Zhang, Peipei Wang, Meixi Liu, Yu Liu, Hongli Jing
Journal: Clinical Nuclear Medicine (2023)

A 61-year-old man underwent a resection of tumor in the left tibia that caused osteomalacia 11 years ago. Postoperative bone pain and fatigue symptoms were briefly relieved but then recurred. To identify potential recurrent tumors, 99m Tc-HYNIC-TOC scintigraphy was performed. Images revealed an osteolytic lesion in the right tibia with increased uptake. The lesion was subsequently resected, which pathologically proved a brown tumor. Symptoms of bone pain and weakness caused by osteomalacia did not relieve 4 months after the operation. Here, we present a rare case of brown tumor with high activity on 99m Tc-HYNIC-TOC SPECT/CT, mimicking a culprit tumor of osteomalacia.
18F-FDG PET/CT Imaging of Pulmonary Hamartomas
Authors: Sharjeel Usmani, Anjali Jain, Syed M. J. Akhter, Khulood Al Riyami, Sofiullah Abubakar, Asiya Al Busaidi
Journal: Clinical Nuclear Medicine (2023)

Abstract Pulmonary hamartoma is the most common benign tumor of the lung and often discovered incidentally on imaging. We report the case of a 49-year-old woman recently diagnosed with left breast cancer with suspicious left axillary lymph nodes. 18 F-FDG PET/CT showed well-circumscribed, lobulated, low-attenuation soft tissue mass in the right lower lobe lung with mild to no significant metabolic activity. CT-guided biopsy showed the lesion composed of fat, cartilage, and smooth muscle, admixed with fibroconnective tissue. The findings are consistent with pulmonary hamartoma. The presence of fat in a well-circumscribed solitary pulmonary nodule along with low metabolic activity helps in the characterization of the lesion, which can alter patient management.
Diagnostic Superiority of 18F-FDG PET Over MRI in Detecting Anti-LGI1 Autoimmune Encephalitis
Authors: Menglin Liang, Na Niu, Chenhao Jia, Siyuan Fan, Linwen Liu, Ruixue Cui, Hongzhi Guan
Journal: Clinical Nuclear Medicine (2023)

Our study aimed to investigate the utility of 18 F-FDG PET imaging in diagnosing and monitoring patients with anti-leucine-rich glioma-inactivated 1 antibody autoimmune encephalitis (anti-LGI1 AE). We also sought to understand the mechanisms of faciobrachial dystonic seizures (FBDSs).We analyzed 18 F-FDG PET scans from 50 patients with anti-LGI1 AE, using visual and semiquantitative methods, and compared these with 24 healthy controls. All patients tested positive for anti-LGI1 antibodies in serum or cerebrospinal fluid before PET imaging. The patients were divided into FBDS and non-FBDS groups to compare metabolic differences using voxel-based semiquantitative analysis. Finally, we separately analyzed PET images of patients with symptom recurrence.The sensitivity of 18 F-FDG PET was superior to MRI (97.9% vs 63.8%, respectively; P < 0.001). Semiquantitative analysis revealed hypermetabolism in the basal ganglia, medial temporal lobe, and brainstem, and hypometabolism in most neocortical regions compared with healthy controls. The FBDS group exhibited hypometabolism in the frontal and temporal lobes compared with the non-FBDS group. Among 7 recurrent patients, 3 were confirmed as recurrence and 3 as sequelae by PET. One patient relapsed shortly after discontinuing corticosteroids when PET indicated active lesions.18 F-FDG PET scans were more sensitive than MRI in detecting anti-LGI1 AE, which displayed a pattern of hypermetabolism in the basal ganglia and medial temporal lobe, as well as neocortex hypometabolism. Hypometabolism in the frontal and temporal lobes was associated with FBDS. Furthermore, 18 F-FDG PET scans can differentiate recurrence from sequelae and guide the timing of immunotherapy cessation.
68Ga-FAPI–Avid Submental Ectopic Papillary Thyroid Carcinoma and Lateral Neck Lymphadenopathy With Low 18F-FDG Uptake
Authors: Yuan Shi, Linglin Tang, Mengjia Fei, Jianjun Liu, Zhuoying Wang
Journal: Clinical Nuclear Medicine (2023)

Ectopic thyroid tissue is rare and generally occurs along the thyroglossal duct or in lateral cervical region. We reported 18 F-FDG and 68 Ga-FAPI findings of a 28-year-old woman with previously diagnosed BRAF -mutated lateral lymph node metastasis of unknown primary site. Low 18 F-FDG but increased 68 Ga-FAPI uptake was seen in a submental pretracheal nodular lesion. Postsurgical pathologic report verified the diagnosis of ectopic papillary thyroid carcinoma. High FAP expression in the tumor sample corresponded to its imaging manifestations.
Self‐Assembled Virus‐Like Particle Vaccines via Fluorophilic Interactions Enable Infection Mimicry and Immune Protection
Authors: Yinhe Xia, Kai Liu, Fei Wang, Zhou Xu, Yuesheng Wang, Rongling Zong, Yemin Xu, Ping Li, Bin Deng, Maolei Xu, Gang Chen
Journal: Advanced Healthcare Materials (2023)

Influenza epidemics persistently threaten global health. Vaccines based on virus-like particles (VLPs), which resemble the native conformation of viruses, have emerged as vaccine candidates. However, the production of VLPs via genetic engineering remains constrained by challenges such as low yields, high costs, and being time consuming. In this study, a novel VLP platform is developed that could mimic infection and confer influenza protection through fluorination-driven self-assembly. The VLPs closely mimick the key steps in viral infection including dendritic cell (DC) attachment and pH-responsive endo-lysosomal escape, which enhances DC maturation and antigen cross-presentation. It is also observed that the VLPs migrate from the injection site to the draining lymph nodes efficiently. Immunization with VLPs triggers both Th1 and Th2 cellular responses, thereby inducing an improved CD8
Solitary Axillary Lymph Node Metastasis From Bladder Cancer Detected by FDG PET/CT
Authors: Yan Deng, Yujiao Deng, Hao Wang, Hongjun Xie, Wei Zhang
Journal: Clinical Nuclear Medicine (2023)

Solitary axillary lymph node metastasis from bladder cancer is rare. A 65-year-old woman with a history of bladder urothelial carcinoma presented to our hospital with an axillary mass. No abnormal lesion in FDG PET/CT was identified except a solitary soft tissue mass with significant FDG uptake in the right axilla. Puncture pathology of the mass confirmed the metastasis of differentiated urothelial carcinoma.
Investigating a Causal Role for Lung Microbiome Dysbiosis in Early Chronic Obstructive Pulmonary Disease Pathogenesis
Authors: Alexa A. Pragman
Journal: American Journal of Respiratory and Critical Care Medicine (2023)

"Investigating a Causal Role for Lung Microbiome Dysbiosis in Early COPD Pathogenesis." American Journal of Respiratory and Critical Care Medicine, 0(ja), pp.
Increased brain microvascular hemoglobin concentrations in children with cerebral malaria
Authors: Rachel L. Smith, Allison K. Ikeda, Carol A. Rowley, Amit Khandhadia, Alexander M. Gorbach, Yamikani Chimalizeni, Terrie E. Taylor, Karl Seydel, Hans C. Ackerman
Journal: Science Translational Medicine (2023)

Brain swelling is associated with death from cerebral malaria, but it is unclear whether brain swelling is caused by cerebral edema or vascular congestion-two pathological conditions with distinct effects on tissue hemoglobin concentrations. We used near-infrared spectroscopy (NIRS) to noninvasively study cerebral microvascular hemoglobin concentrations in 46 Malawian children with cerebral malaria. Cerebral malaria was defined by the presence of the malaria parasite Plasmodium falciparum on a blood smear, a Blantyre coma score of 2 or less, and retinopathy. Children with uncomplicated malaria (n = 33) and healthy children (n = 29) were enrolled as comparators. Cerebral microvascular hemoglobin concentrations were higher among children with cerebral malaria compared with those with uncomplicated malaria [median (25th, 75th): 145.2 (95.2, 190.0) μM versus 82.9 (65.7, 105.4) μM, P = 0.008]. Cerebral microvascular hemoglobin concentrations correlated with brain swelling score determined by MRI (r = 0.37, P = 0.03). Fluctuations in cerebral microvascular hemoglobin concentrations over a 30-min time period were characterized using detrended fluctuation analysis (DFA). DFA determined self-similarity of the cerebral microvascular hemoglobin concentration signal to be lower among children with cerebral malaria compared with those with uncomplicated malaria [0.63 (0.54, 0.70) versus 0.91 (0.82, 0.94), P < 0.0001]. The lower self-similarity of the hemoglobin concentration signal in children with cerebral malaria suggested impaired regulation of cerebral blood flow. The elevated cerebral tissue hemoglobin concentration and its correlation with brain swelling suggested that excess blood volume, potentially due to vascular congestion, may contribute to brain swelling in cerebral malaria.
Fibroblast Activation Protein–Targeted PET/CT Imaging in a Treatment-Naive Prostate Cancer Patient With Low PSMA Expression
Authors: Xingyu Mu, Meng Li, Jingquan Huang, Zhenzhen Wang, Wei Fu
Journal: Clinical Nuclear Medicine (2023)

Abstract Prostate-specific membrane antigen (PSMA) PET/CT has become increasingly accepted for imaging prostate cancer (PCa), including its recent use in primary staging. In this case report, we present the case of a 76-year-old man with newly diagnosed PCa. 18 F-PSMA-1007 PET/CT showed minimal PSMA activity in the primary tumor and metastases. However, 18 F-FAPI-04 PET/CT revealed more avid lesions in primary tumor, metastatic lymph nodes, and bones. Subsequent histopathologic examination confirmed the diagnosis of PCa. These findings suggest that 18 F-FAPI-04 may have a potential role in the evaluation of PCa with low PSMA expression in treatment-naive patients.
Minocycline-induced Acute Fibrinous and Organizing Pneumonia
Authors: Toshiyuki Sumi, Kotomi Terai, Keito Suzuki, Yuta Koshino, Takumi Ikeda, Hiroki Watanabe, Yuichi Yamada, Hirofumi Chiba
Journal: American Journal of Respiratory and Critical Care Medicine (2023)

"Minocycline-induced Acute Fibrinous and Organizing Pneumonia." American Journal of Respiratory and Critical Care Medicine, 208(12), pp. e47–e48
Domain-based mRNA vaccines encoding spike protein N-terminal and receptor binding domains confer protection against SARS-CoV-2
Authors: Guillaume B. E. Stewart-Jones, Sayda M. Elbashir, Kai Wu, Diana Lee, Isabella Renzi, Baoling Ying, Matthew Koch, Caralyn E. Sein, Angela Choi, Bradley Whitener, Dario Garcia-Dominguez, Carole Henry, Angela Woods, LingZhi Ma, Daniela Montes Berrueta, Laura E. Avena, Julian Quinones, Samantha Falcone, Chiaowen J. Hsiao, Suzanne M. Scheaffer, Larissa B. Thackray, Phil White, Michael S. Diamond, Darin K. Edwards, Andrea Carfi
Journal: Science Translational Medicine (2023)

With the success of messenger RNA (mRNA) vaccines against coronavirus disease 2019, strategies can now focus on improving vaccine potency, breadth, and stability. We designed and evaluated domain-based mRNA vaccines encoding the wild-type spike protein receptor binding domain (RBD) or N-terminal domain (NTD) alone or in combination. An NTD-RBD-linked candidate vaccine, mRNA-1283, showed improved antigen expression, antibody responses, and stability at refrigerated temperatures (2° to 8°C) compared with the clinically available mRNA-1273, which encodes the full-length spike protein. In BALB/c mice administered mRNA-1283 as a primary series, booster, or variant-specific booster, similar or greater immune responses from viral challenge were observed against wild-type, beta, delta, or omicron (BA.1) viruses compared with mRNA-1273-immunized mice, especially at lower vaccine dosages. K18-hACE2 mice immunized with mRNA-1283 or mRNA-1273 as a primary series demonstrated similar degrees of protection from challenge with SARS-CoV-2 Delta and Omicron variants at all vaccine dosages. These results support clinical assessment of mRNA-1283, which has now entered clinical trials (NCT05137236).